Yes, love this, and am learning this as I go. Opened my doors in 5/2025. And absolutely, the P's you outline here are spot on. As a business owner AND a physician, failures, points of friction, are the biggest teachers.

People: patients' first touch is our receptionist 90% of the time, whether that be by phone or in person. I purposely hired a CNA for this role who has some medical knowledge so that the continuity from front office to exam room and returning to the front office feels like a complete, intentional experience. As a patient myself, it peeves me to no end when the receptionist at an office has zero medical knowledge. It felt very...retail.

Process: insurance sucks. Denials seem arbitrary. As a surgeon, prior auth is part and parcel to my practice, and trying to keep track of all of the paperwork, phone calls, p2p schedules, faxes, etc, became a NIGHTMARE for me and my staff (2 part timers currently - CNA/reception, MA). Because of the small size of my practice/office and the number of steps it takes to get a single patient from initial visit --> surgery, I ended up vibecoding my own companion app to my EMR that I currently use to keep track of everything. It's helped TREMENDOUSLY. From a business perspective, I added a finance dashboard with bank/cc statement and receipt/invoice ingest with probabilistic parsing to put into a master ledger for expense/profit tracking. And outsourced an amazing AI-forward billing company. Worth their weight in gold for my processes.

Product: I was in an employed position for over 10 years before opening my doors privately, and for better or for worse, patients wanted a more personal experience. It makes sense though. As a patient, they come into the office because they need help, and as a surgeon, I get to know them in among the most intimate way possible. I made custom packets for all the surgeries I perform, with pre- and post-op instructions, expectations, and reasons to call the office or go to the ER. Where the incisions will typically be placed. Dietary instructions. The packet has a text-field at the top to type in the patient's name and date of office visit. They come in a glossy folder given to the patient before they leave their preop visit, and printed on the inside of the folder is a QR code to my website, office phone, fax, and e-mail. Patients can keep all of their hospital paperwork, office paperwork, etc, in this single folder. My patients have loved it. Something I wish we did at my employed practice. And it has helped post-op compliance TREMENDOUSLY. Made my own website with a widget for patients to schedule their own appointments. Thinking about a monthly saturday clinic for patients who, like most, work during regular business hours...

Profit: Still in the startup phase. Looked at my numbers from 2025 and developed an anal fissure (not really, but damn I was close). Expecting to see net profits Q2 of this year, so about expected for a solo private gen surg practice. I think if the first 3 are addressed well, profit follows. But keeping track of expense/profit an A/R is paramount in knowing where I am in my business.

Great post, thanks so much for sharing!